Ana-Maria Orbai, M.D., M.H.S., is a rheumatologist at the Johns Hopkins. An additional paper, currently in preparation, examines the downstream impact of the CSI on children's psychosocial wellbeing. Fatigue, joint pain and skin problems are some symptoms of autoimmune diseases. That paper is currently in press with Social Science and Medicine-Mental Health. The results of a process evaluation, based on focus groups conducted with half of the trial participants fro0m the CSI arm, explores the CSI pathways of impact, and examines the impact of extreme adversity on the effects of the CSI over time. The findings were published in the Journal of Child Psychology and Psychiatry (2022). We recently published the findings of our fully powered randomized controlled trial of the CSI, with 480 caregivers from 240 families, primarily Syrians in North Lebanon. This report describes the historical evolution, development, rationale and validation of the Hopkins Symptom Checklist (HSCL), a self-report symptom inventory. The primary goal of this project is to develop and rigorously evaluate a preventive group intervention, the Caregiver Support Intervention (SCI), for conflict-affected caregivers aimed at supportin g their parenting through two pathways: primarily, by strengthening their own wellbeing, and secondarily, by supporting their use of positive parenting methods.
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